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Peptic Ulcers

Rakesh GUPTA
Rakesh GUPTA MD
New York, Brooklyn
Gastroenterology
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* Date : 08-20-2009 - 11:10 PM (5354 days ago),

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Peptic Ulcers

What is a peptic ulcer?
A peptic ulcer is a sore in the lining of your stomach or duodenum. The duodenum is the first part of your small intestine. If peptic ulcers are found in the stomach, they're called gastric ulcers. If they're found in the duodenum, they're called duodenal ulcers. You can have more than one ulcer.

Many people have peptic ulcers. Peptic ulcers can be treated successfully. Seeing your doctor is the first step.

What are the symptoms of peptic ulcers?
A burning pain in the gut is the most common symptom. The pain

feels like a dull ache
comes and goes for a few days or weeks
starts 2 to 3 hours after a meal
comes in the middle of the night when your stomach is empty
usually goes away after you eat

Other symptoms are

losing weight
not feeling like eating
having pain while eating
feeling sick to your stomach
vomiting

Some people with peptic ulcers have mild symptoms. If you have any of these symptoms, you may have a peptic ulcer and should see your doctor.

What causes peptic ulcers?
Peptic ulcers are caused by

bacteria called Helicobacter pylori, or H. pylori for short
nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen
other diseases

Your body makes strong acids that digest food. A lining protects the inside of your stomach and duodenum from these acids. If the lining breaks down, the acids can damage the walls. Both H. pylori and NSAIDs weaken the lining so acid can reach the stomach or duodenal wall.

H. pylori causes almost two-thirds of all ulcers. Many people have H. pylori infections. But not everyone who has an infection will develop a peptic ulcer.

Most other ulcers are caused by NSAIDs. Only rarely do other diseases cause ulcers.

Do stress or spicy foods cause peptic ulcers?
No, neither stress nor spicy foods cause ulcers. But they can make ulcers worse. Drinking alcohol or smoking can make ulcers worse, too.

What increases my risk of getting peptic ulcers?
You're more likely to develop a peptic ulcer if you

have an H. pylori infection
use NSAIDs often
smoke cigarettes
drink alcohol
have relatives who have peptic ulcers
are 50 years old or older

Can peptic ulcers get worse?
Peptic ulcers will get worse if they aren't treated. Call your doctor right away if you have any of these symptoms:

sudden sharp pain that doesn't go away
black or bloody stools
bloody vomit or vomit that looks like coffee grounds

These could be signs that

the ulcer has gone through, or perforated, the stomach or duodenal wall
the ulcer has broken a blood vessel
the ulcer has stopped food from moving from the stomach into the duodenum



These symptoms must be treated quickly. You may need surgery.

How can I find out whether I have peptic ulcers?
If you have symptoms, see your doctor. Your doctor may

take x rays of your stomach and duodenum, called an upper GI series. You'll drink a liquid called barium to make your stomach and duodenum show up clearly on the x rays.

use a thin lighted tube with a tiny camera on the end to look at the inside of your stomach and duodenum. This procedure is called an endoscopy. You'll take some medicine to relax you so your doctor can pass the thin tube through your mouth to your stomach and duodenum. Your doctor may also remove a tiny piece of your stomach to view under a microscope. This procedure is called a biopsy.

If you do have a peptic ulcer, your doctor may test your breath, blood, or tissue to see whether bacteria caused the ulcer.

How are peptic ulcers treated?
Peptic ulcers can be cured. Medicines for peptic ulcers are

proton pump inhibitors or histamine receptor blockers to stop your stomach from making acids
antibiotics to kill the bacteria

Depending on your symptoms, you may take one or more of these medicines for a few weeks. They'll stop the pain and help heal your stomach or duodenum.

Ulcers take time to heal. Take your medicines even if the pain goes away. If these medicines make you feel sick or dizzy, or cause diarrhea or headaches, your doctor can change your medicines.

If NSAIDs caused your peptic ulcer, you'll need to stop taking them. If you smoke, quit. Smoking slows healing of ulcers.

Can I use antacids?
Yes. If you have a peptic ulcer, taking antacids will

stop the acids from working and reduce the pain
help ulcers heal

You can buy antacids at any grocery store or drugstore. But you must take them several times a day. Also, antacids don't kill the bacteria, so your ulcer could come back even if the pain goes away.

Can peptic ulcers come back?
Yes. If you stop taking your antibiotic too soon, not all the bacteria will be gone and not all the sores will be healed. If you still smoke or take NSAIDs, your ulcers may come back.

What happens if peptic ulcers don't heal? Will I need surgery?
In many cases, medicine heals ulcers. You may need surgery if your ulcers:

don't heal
keep coming back
perforate, bleed, or obstruct the stomach or
duodenum

Surgery can

remove the ulcers
reduce the amount of acid your stomach makes

What can I do to prevent peptic ulcers?
Stop using NSAIDs. Talk with your doctor about other pain relievers.


What can I do to lower my risk of getting peptic ulcers?
Don't smoke.
Don't drink alcohol.

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